Experimental Application of Extracorporal Circulation to Acute Gas Poisoning
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概要
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Among such poisonous gases as carbon monoxide, nitrogen oxide, ozone and sulfur dioxide, carbon monoxide is porbably the most widespread poisoning hazard. Here is carbon monoxide poisoning refered to.CO is only toxic because it reacts with hemoglobin to form carboxyhemoglobin (HbCO). The affinity of hemoglobin for CO, expressed as K, is 200-300 times its affinity for O2. In a given blood with the value of K, heat decreases the affinities of both gases for hemoglobin, but affects that of CO more than that of O2. Light greatly lowers the affinity of CO for hemoglobin, but has relatively little effect on the affinity of oxygen. Hence increase in either temperature or illumination lowers the value of K and assist oxygen in displacing CO from the hemoglobin molecule. If one expects to treat CO poisoned patients not only by oxygen administration but also by decreasing the affinity of CO for hemoglobin, an application of extracorporal circulation is necessary to perform above procedure.This past decade has wittnessed the introduction and subsequent development of temporary total or partial extracorporal circulation as a routine and useful surgical technique. Our order-made plastic chamber has multiple abilities to oxygenate, thermoregulate and illuminate the blood in the extracorporal circuit. Using this chamber we studied the rate of decrease in HbCO under such various conditions as at 40°C, illumination of a 10W. ultra-violet lamp and oxygenation with 10% CO2 containing oxygen.Following results were obtained in our circuit; oxygenation alone decreased 68% of HbCO to 45%, oxygenation plus 40°C heat decreased 74% to 35%, oxygenation plus illumination 66% to 36, and oxygenation plus lowered pH 63% to 37%. The oxygenation plus heat, illumination and lowered pH together decreased 65% to only 36%, showing no additive effects of those combined.When much improvement of oxygenator is made to facilitate above-mentioned procedure, the rapid removal of CO from lethally saturated blood is possible with the use of equipment that is cheap, rapid to assemble, and already widely available.
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